Clinical manifestation

May begin with non-specific constitutional symptoms and signs; prodromal pain or parathesias along one or more der-matomes, lasting i-i0 days, followed by patchy erythema in the dermatomal area of involvement and regional lymphadenopa-thy; unilateral, grouped vesicles on ery-thematous base, with severe local pain; vesicles initially clear, but eventually becoming pustular, rupturing, crusting, and involuting; scarring ensues if deeper epidermal and dermal layers compromised by scratching, secondary infection, or other complications

Disseminated zoster: generalized eruption of more than i5-25 extradermatomal vesicles, occurring 7-i4 days after the onset of dermatomal disease; occurs rarely in the general population, but commonly in elderly, hospitalized, or immunocompromised patients; often an indication of depressed cell-mediated immunity caused by various underlying clinical situations, including malignancies, radiation therapy, cancer chemotherapy, organ transplants, and chronic use of systemic corticosteroids; dissemination sometimes includes involvement of the lungs and central nervous system